MS. TRACEY LATONYA BLACKBURN NPI 1629551304

NPI Information

  • NPI: 1629551304
  • Provider Name: MS. TRACEY LATONYA BLACKBURN
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • Address: 1717 RAND RD
    DES PLAINES, IL
    ZIP 60016
  • Phone: (773) 294-5797

Map and Directions

Get Directions

NPI Details

MS. Tracey Latonya Blackburn is a mental health counselor in Des Plaines, IL. MS. Tracey Latonya Blackburn NPI is 1629551304. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1717 RAND RD
DES PLAINES, IL
ZIP 60016-509
Phone: (773) 294-5797

The enumeration date for this NPI number is 9/10/2018 and was last updated on 9/27/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1362170821061MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.